Individual provider Active NPI

Suman Kaza, MD

  • Neurology Physician
  • Detroit, MI
National Provider Identifier
1063907046
Registry record updated Nov 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
MD480514 Issued in PA
Practice address
22201 Moross Rd Ste 50
Detroit, MI 48236-2166
Phone
(313) 343-7774
Fax
(313) 343-8747
NPI assigned
Jun 22, 2018
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 10, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular Neurology Physician 2084V0102X MD480514 PA
Student in an Organized Health Care Education/Training Program 390200000X 4301116003 MI
Neurology Physician 2084N0400X MD480514 PA Primary

Addresses

Primary practice location

22201 Moross Rd Ste 50
Detroit, MI 48236-2166

Mailing address

1000 E Mountain Dr
Wilkes Barre, PA 18711-0027
Phone (570) 808-7300

Other practice location 1

228 Saint Charles Way Ste 200
York, PA 17402-4661
Phone (717) 851-5503

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in HI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241023003534 HI Practitioner - Neurology 5294081295 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Queens University Medical GroupGroup PAC ID 2466831557, 614 clinicians

Practice addresses (Care Compare)

1301 Punchbowl St
Honolulu, HI 96813-2499

1380 Lusitana St
Honolulu, HI 96813-2448

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
4301116003MIMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
The Queens Medical Center CurrentSince Nov 4, 2024 Accepting new patients
Queens North Hawaii Community Hospital CurrentSince Jan 1, 2026 Accepting new patients
The Queen'S Medical Center Current Accepting new patients
The Queens Medical Center CurrentSince Nov 4, 2024 Accepting new patients
Queens University Medical Group CurrentSince Nov 4, 2024 Accepting new patients
Upmc Altoona Regional Health Services, Inc Neurology CurrentSince Jun 26, 2023 Accepting new patients
Upmc Altoona Regional Health Services, Inc Current Accepting new patients
The Queens Medical Center - Progressive Care Unit Past Accepting new patients

Locations

550 S Beretania St
Ste 404
Honolulu, HI 96813
Phone (808) 691-8897

1380 Lusitana St
Ste 913
Honolulu, HI 96813
Phone (808) 691-8521

1301 Punchbowl St
Honolulu, HI 96813
Phone (808) 538-9011

67-1125 Mamalahoa Hwy
Kamuela, HI 96743
Phone (808) 881-4400

1414 9th Ave
Altoona, PA 16602
Phone (814) 949-7621

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699574400000",
    "number": "1063907046",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 E MOUNTAIN DR",
            "city": "WILKES BARRE",
            "state": "PA",
            "postal_code": "187110027",
            "telephone_number": "570-808-7300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22201 MOROSS RD STE 50",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362166",
            "telephone_number": "313-343-7774",
            "fax_number": "313-343-8747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Saint Charles Way Ste 200",
            "address_purpose": "LOCATION",
            "city": "York",
            "state": "PA",
            "postal_code": "174024661",
            "country_code": "US",
            "telephone_number": "717-851-5503",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KAZA",
        "first_name": "SUMAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-22",
        "last_updated": "2023-11-10",
        "certification_date": "2023-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084V0102X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Vascular Neurology",
            "state": "PA",
            "license": "MD480514",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301116003",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD480514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.